03 Feb Procuring PPE during COVID-19: A Case Study
In 2020 the Commissioning Alliance (CA) led the largest regional PPE procurement response in the UK, sourcing 60 million units of PPE for Local Authorities across London. They coordinated the distribution of a further 21m units of PPE to support front line Social Care providers in partnership with the Department for Health and Social Care (DHSC), whilst also securing donations of 1 million Type IIR masks and 5,000 litres of Hand Sanitiser for front line care workers.
The team are rightly extremely proud of this contribution they have made to reducing the impact of COVID-19. Below is a case study detailing the journey they went on to be able to deliver at this scale and pace, no mean feat considering the complex national and international context they were operating in. It serves as both a useful and inspirational reminder of what can be achieved when working collaboratively, not just within west London, but across the whole of the London region.
The Initial impact of COVID-19 and the PPE shortage
There’s no doubt we all felt the impact of COVID-19, and it was no different for our Local Authorities; having to respond to constantly changing operational challenges at pace was an almost daily occurrence. As a sub-regional commissioning organisation with excellent networks and experience with large-scale procurements, WLA Chief Executives realised the Commissioning Alliance were well-placed to lead the sourcing of PPE for west London.
The team began connecting with potential suppliers, but stock was severely limited as demand continued to outstrip supply. This was in part due to the international context with countries including China and the USA buying-up entire PPE factories and banning exports to meet their own requirements – reportedly even stopping planes on runways to ensure that PPE was not exported. This exposed the vulnerabilities of relying on a global supply chain during a global emergency.
Through market engagement and leveraging existing networks, the Commissioning Alliance were able to secure suppliers from both abroad and new suppliers within the UK. In a matter of days, PPE began to flow into west London.
This PPE was both high-quality and represented value for money, being lower in cost than PPE sourced by both the NHS and other Local Authorities in England. Over the course of the project, this represented estimated savings of £4m of public funds*.
Distribution and Payments
Distribution was the next consideration; how best to get the PPE to Local Authorities and then on to the people who urgently needed it? Ealing Council had quickly established a PPE hub and the CA collaborated with them to enable effective distribution. The team were also supported by a group of fantastic volunteers, offering their time and vehicles to ensure PPE was distributed to those that desperately needed it, whilst a strategic weekly delivery approach was put in place.
Support from the Ealing PPE hub was critical; they provided quality assurance on shipments and split stock into onward deliveries. They also took on the responsibility of central payments for all stock to ensure we could quickly guarantee supplies and cash flow into the supply chain to make this sustainable.
Risks
The risk of PPE fraud worsened as the pandemic wore on. Stories of organised crime producing sub-standard PPE or fraudulent certification being provided with PPE deliveries became an increasing risk. There was footage of deliveries containing boxes filled with rags, and stories of deposits being paid and orders not arriving. The trust in the Commissioning Alliance’s supply chain became just as critical, if not more, than the unit cost being achieved.
Changes in guidance were common as more was learnt about the virus and the appropriate PPE to use in different settings. This added complexity, especially when sourcing PPE from abroad in ensuring specifications were correct and matched UK guidance.
Another challenge was the almost daily increase in costs, for example, nitrile gloves, which went from 0.05p – 0.18p in a matter of weeks. Not only was demand far outstripping supply, lockdowns across the globe and the reduction in commercial flights meant air freight costs increased significantly.
These risks were managed through a combination of:
i) negotiating long-term, large orders with providers, benefitting from economies of scale;
ii) building relationships with numerous trusted providers to secure high-quality stock wherever possible;
iii) working with UK-based manufacturers where possible; and
iv) establishing strong relationships and regular communication with pan-London PPE leads, sharing constantly changing information.
The PPE supply chain was established by April and within the first 2 months, over 15 million units of PPE was making its way to Care Homes and care settings across the sub-region. Any minor quality issues were rectified quickly and effectively by suppliers making the Commissioning Alliance supply a trusted source for Local Authorities across London.
Value for money
Based on information submitted into the Local Government Association (LGA) from over 19 Local Authorities / County Councils in England, the Commissioning Alliance were able to make a comparison on the value we managed to achieve. In all cases we were equal to, or below, the lowest cost for any line we sourced during the first 8 months of the pandemic, saving millions of pounds of public money. This equated to estimated savings of £4m during this period*.
Expansion of approach
In light of the success in establishing this trusted supply chain for west London, the Commissioning Alliance was asked to source PPE for all London boroughs. They continued the same partnership ‘hub and spoke model’ which was working well in west London with 5 regional hubs serving all 33 London Boroughs.
Through this model, the Commissioning Alliance were able to source and distribute 60 million units of PPE across London, underpinning the response to COVID-19 in care homes and beyond to protect the most vulnerable residents and vital frontline care workers.
The Department of Health and Social Care (DHSC) announced they were opening their PPE stocks to support care providers and acute settings from October 2020. This included a direct access route for supplies via the Government’s PPE Portal and via Local Authorities and Local Resilience Forums. The Commissioning Alliance took on coordinating the distribution of PPE to all the LAs across London. Supported by the Royal Free Hospital in Enfield and individual London Boroughs, this approach has to date, coordinated over 21 million units of PPE to London.
Donations
During our PPE sourcing, the Commissioning Alliance engaged with organisations that helped secure donations to support front line social care in London. The Scheinberg Relief Fund and One World Medical donated 1 million TypeIIR masks that helped support over 700+ care homes in London and was a fantastic contribution to supporting front line care workers at a critical time during the first peak of the crisis.
The Commissioning Alliance also partnered with Imperial College London’s Engineering department worked with Sipsmith’s to provide alcohol hand sanitizers for Care Homes across London with over 9,000 litres of sanitizer being distributed to front line social care.
The Future
The coordinated effort of sourcing and distributing PPE was complex and challenging. James Weaver, Commissioning Alliance Head of Operations and Business Support, who led the effort said “it was an honour to work with our colleagues across Local Authorities and in the external organisations supporting the efforts to get much needed PPE to the front line. The commitment and support from LA PPE leads has been truly amazing and has shown the resilience of Local Authorities when faced with the toughest of challenges”.
Central government PPE support is set to continue, but for how long and to what degree remains unknown for now. The Commissioning Alliance is looking at other ways to help support the continued supply, potentially though setting up procurements to secure the supply of PPE for the foreseeable future with fair and open competition to secure the best quality and value for money for Local Authorities and Care providers.
For more information or to get in touch with the team, please contact: commissioningalliance@ealing.gov.uk
*This figure is based on benchmark data collated by the Greater London Authority (GLA) on prices achieved on average by Local Authorities during the initial phase of the pandemic.
Risks